HCP-16POPULATION-BASED SURVIVAL RATES FROM HIGH GRADE GLIOMA (HGG) ARE NOT IMPROVED BY INCREASED CHEMOTHERAPY USE

BACKGROUND: Clinical trials favor aggressive therapy for glioblastoma. Maximally safe surgical resection, radiotherapy, and temozolomide chemotherapy are considered standards of care. However, it is unclear if these treatments improve population-based overall survival, as the selection criteria used in clinical trials are often relatively narrow. METHODS: We prospectively collected patients registered in a population-based database for primary HGGs (n = 363) treated in Rochester, NY from 2000 to 2014. We sought to track survival trends and evaluate treatment efficacies. RESULTS: The median age at diagnosis was 61 years. The majority of patients were white (94.5%) with glioblastoma (77.7%). Most (84.3%) had died (all causes) during the follow-up interval. Overall, patients who received combination treatment of surgery, radiation and chemotherapy have better survival (median 490.0 days) than those who received combination of surgery and radiation therapy (median 239.0 days, p u003c 0.001) or surgery alone (median 95.0 days, p u003c 0.001). We further grouped patients into three time periods for comparison: 2000 to 2004, 2005 to 2009, and 2010 to 2014. We found no appreciable differences in the median, 6-month, and 2-year survivals between each time interval (median survival time: 368.0 vs. 360.0 vs. 358.0 days, respectively). Notably, the rate of combination of surgery, radiation and chemotherapy significantly increased over the time (32.5% vs. 64.0% vs. 67.6%, respectively). We also observed that patients who received surgery and radiation therapy had a better survival time during 2000 to 2004 (median 275.5 days) compared to those in 2005 to 2009 (median 89.0 days, p u003c 0.05). CONCLUSIONS: Our data indicate that while temozolomide chemotherapy clearly improves survival with HGG, its benefit is limited to a subset of patients. Expanding its use to all HGG as is now common practice does not improve overall patient population survival. A more personalized usage strategy for temozolomide is needed.